Provider Demographics
NPI:1720509821
Name:KAKAS, MELANIE (PA-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:KAKAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 N CALVERT ST STE 400
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-6501
Mailing Address - Country:US
Mailing Address - Phone:856-371-8988
Mailing Address - Fax:410-554-6768
Practice Address - Street 1:3333 N CALVERT ST STE 400
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-6501
Practice Address - Country:US
Practice Address - Phone:410-554-6890
Practice Address - Fax:410-554-6768
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant